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HomeMy WebLinkAboutMiscellaneous - 164 ROSEMONT DRIVE 4/30/2018 164 ROSEMONT DRIVE 210/098.6-0038-0000.0 ` i Location No. "7 �-3 Date r HORTN - TOWN OF NORTH ANDOVER o? � os � A ` Certificate of Occupancy $ MUU Eta Building/Frame Permit Fee $ AC S Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �� tt k Check # I r 16 00, 90 6/ —Building Inspector d" TOWN OF NORTH ANDOVER • BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED. `y 7 O SIGNATURE: AI Building Commissionerfl2gwor of Buildings Date SECTION 1-SITE INFORMATION 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Lerse -� S f- . e)q9./3 0030 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: W Zoning District Proposed Use I Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 0 1.7 Water Supply M.G I.C.40. S4) 1.3. Flood Zane Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes,,__No M 2.1 Owner of Record Name(Print) Address for Service O Signature Telephone 2.2 Owner of Record: i Name Print Address for Service: O Si naiure Telephone M SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ wvt D h� 0 Licensed Construction Supervisor: 1 T—S PC—./LA,�i t04. License Number Address 6 03- -31f. a - v two Expiration Date ic Signature Telephone r 3.Z'Registered Home Improvement Contractor Not Applicable ❑ Company Name � Registration Number Address Expiration Date ^� Si na re Telephone YS F SECTION 4-WORKERS COMPENSATION(M:G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building rmit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check allapplicable) New Construction 11 Existing Building ❑ Repair(s) 11Alterations(s) 11Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be LAL-,USEv0NL-Nqoi UNI.Y Completed by permit applicant . .. . 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1'*2+3*4+5)'r Check Number //0 / SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, 1N-: 1-t ( 11x 0a-Z-S as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief ^ , '1�k;L D t Prin e Si Are of`O er/A I ent Date NO.OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TIMBERS 1 2ND 3 SPAN DIMENSIONS OF SILLS . . DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS ; HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHFANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE REMITTANCE ADVICE NOVA KITCHENS, 77777777 LLC sa 7osa 7lsiand Pond Road Atkon New liampshlre 0381.1 (603)362 6480; = NO _Ne AOU NT, LG'a_ CHECK NO 77 DOLLARS PAID TO _ GROSS AM7 FICA FED TAX 'ST TAX NET AMOUNT _ - P f MENTDESCRIPTION DISC, Q$�hkf1101'th 370 Maw Sheet - - _ Worcester MA Q]6D8 Massachusetts ktRFiORIZED _u'00L10tu. �i'2il`3 ?0545 :=B2479�,0 �,6►' _ . . ..._ . ...... .. ' va- PROPOSAL Richard j. Eric DuBois, Owner Phone: (603) 362-6480 Managing Director,ec ocanat]g]1 NOVA KITCHENS 6gk-, GENERAL CONTRACTING. Fax: (603) 362-8449 Rose Associates,Inc. �y73 7 Island Pond Road. One Financial Center Atkinson, NH 03811-2129 Boston,MA 02111-2651__ Direct Line: 6I )348-3700 Direct Fax:(6I-7)/4 26-9565 Proposal Submitted to: Mrs. Nancy Cavanaugh E-Mail:rjcQrosenyc.com 164 Rosemont Dr. HOUle....r.._ - North Andover, MA. License # 115786 978-682-7817 H. We hereby submit this proposal for the following: Kitchen. Remove all existing kitchen cabinets, counter tops, appliances and place in basement. Install customer supplied cabinets, molding, sink, dishwasher, garbage disposal, faucet, cook top, warming, drawer, wine cooler and microwave/wall oven. Install and wire down draft unit for cook top. Supply/install (4) in-cabinet lights. Relocate one recessed light and repair ceiling to smooth finish. Relocate drain pipe and hot water line. Supply and install one light in pantry closet. Supply plywood and drop cloths to protect existing flooring. Provide dedicated circuits for all new appliances. Move gas line approximately two feet. Job to start on 5/5/03 Total $6040.00 All Material is guaranteed to be as specified and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner. Drop cloths to be used in all traffic areas. Job area to be kept as neat and clean as possible at all times. Job to be completed in a timely manner. Payments to be made as follows: $1000.00 Deposit payable upon acceptance of proposal. $1000.00 to be paid at start of job, $4040.00 balance, due in full, upon job completion Respectfully submitted by: ' do DuBois Any alteration or deviation from above specifications involving extra costs will be executed only upon written order and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays be and our control. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as%utlined above. Signature✓ v Z//. Date____ 4/�� Signature �=� • 1 ,•.�V ✓rie �om�rwozcorea .��✓ aQaaclzecaetta . f BOARD'OF BUILDING'AEGULATIONS . � License': CONSTRUCTIO N SUPERVISOR Number: CS 052746 ` Birthdate. 02/04%1965 Expires 02/04/20x05 Tr.no: 8295 0 Restrjctetl: . 01 ERIC F DUBOIS' } 7 ISLAND POND Rp. ATKINSON, NH 03811, Administrator i s ✓l e �anvrn � a�./ °accc6tuaetta T lugBoard of Building Regulations and Standards e HOME IMPROVEMENT CONTRACTOR Registration 1115786 s �� ExprraUQn_4/{x[3%04 �z := ERIC DUBOIS/NgUA Kf fC1 LENS ERIC DUB IS 7 ISLAND POND ATKINSON,.NH 03811 Administrator u M The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02 911 5,lb Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for rry employees working on this job. Company name: r't_L-C Address 7 S s Phone#. 6 0 Insurance:Co. 'N'Policy# SC-P 0037'7.t.5'3A'7 Company name: Address City`. Phone#. Insurance Co. Policy# Failure to secure coverage as required under Section 2M or MGL 152 can lead to-the imposition of`criminal penalties of,a fine and/or one years'impftonmit ent_as_%vWLLas_c ,pmaitiesialbal m�a�7DP]MIJRK.DRQEP aid_afine-dlODM_ato$1,500:00 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA forcoerage verification. 1 l do hereby certify under Me pains and penalties of perjury that the vgbn anon provided above a Eve and camect. e Signature.. Date Print name '! vk in43 cys Pine Official use only do not write in this area to be completed by city or town official City or Town Permittl icensing. Building Dept []Check ff immediate response is required [J UCensh V Board F1 Selectman's Office Contact person. Phone# Health Department Other T _ i N o rr r M 0" Of Andover No. 3 _- O ms`s LAK . cover, Mass., _ COC HICKS WICK y�. ADRATE D PER M_ S HEALTHFood/kitchen Septic System U BOARD OF HEALTH IT T )_ BUILDING INSPECTOR THIS CERTIFIES THAT...... �.��/?b N �A V.4 ,V 4 v ......................... ........................................ .............................................. Foundation has permission to erect..: ...... buildings on .....�.Gr... ......�Q«� n'IO vim` Rough . .. . ... ... ......... ......... .............. to be occupied as................oie�. .f .. 1/`'♦....... ..IV.......5 rI �!� ......., ►� Chimney .. provided that the person accepting this permit shall in every respect confo m to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Law relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS T �-�p� T ELECTRICAL INSPECTOR d.11�1 DESS CONS 1 R V CTION ST T� « Rough 00 0.40.1till.................. ... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathingor D Wall To Be Cone � FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. I _F SEE REVERSE SIDE Smoke Det. Date...!. �O�a n 3 3?;•_.�`' "�o� TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACMUSEt This certifies that ... ." e C " has permission to perform ........1.�!4 P—'e �'` o� ................................................................. wiring in the building of.......e.!a V A N U ....................... .` ......................................... �oSf' 1`nON � S� at..�.n.`.1........ ......................................................... .North Andover,Mass. ... 3 L J $b!v. ,���o AA� -------- � �9 Fee........5..... Lic.No.............. ............................ .................................. z ELECTRICAL INSPECTOR Check # 3`3? 60 49 + 9 Official Usex, Permit No. ,? 657 Occupant ee Chec BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 ,L (Please Print in ink or type all information) Date To the Inspe for of fres: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number I -"A aAs(31yiCIAT Owner or Tenant i C InAf C,4 V Q VIA l.5�'h Owner's Address S/a%YVI `L Is this permit in conjunction�with a building permit Yes No 0 (Check Appropriate Box) Purpose of Building A l la1 n_ Utility Authorization No. %J Existing Service �^ Amps Voits Overhead 0 Undgrnd 0 No.of Mete New Service ._ Amps Voits Overhead 0 Undgmd F0 No.of Mete Number of Feeders and AmpacityLas r P m l;= Location and Nature of Proposed Electrical Work rs Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above 0 In 0 No.of Lighting Fixtures Swimming Pool gmd 0 gmd 0 Generators KVA No:of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone _ Total No.of Detection and No.ofRanges No of Air Cond Tons Initiating Devices _ Heat Total Total No.of Diposal No. Pumps Tons KW No.of Sounding Devices NoJ of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding.Devices _ 0 Municipal 0 Other No.of Dryers Heating Devices KVV Local Connection No.Of No.of Low Voltage i No.of Water Heaters KW Signs Bailases Wiring a No.Hydro Massage Tuds No.of Motors Total HP OTHER: CA wgi,Z 3 L L Poo( Lt' IRE " 4 IN CE CvVERAGE Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = have submitted valid proof of sam the Office YES= NO - If you have ch YES please indicate the type ofco by checking the appropriate box. INSURANCE - BOND - HE (Please Specify) A, ` as&6 ge (Expiration ate) Estimated Value of.El rica Works Work to Start Inspection Date Resquested Rough Final Signed under the P n/j��tties f per�ry �f/� FIRM NAME ✓�/�`f IY� L LIC.NO. �Dr�y Licensee 1 Si nature_-�� ,��' 9 r -.�,t�� LIC.NO. ((�� gg� Bus.Tel No. 97 G' 6c-/5'- ql / Address Q U 00 x' 3%= !U• C yl�������(j rr Alt Tel.No. y)�� �[�-?:� -5-.sr OWNER'S INSURANCE WAIVER: 1 am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Mass: General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) S Telephone No. PERMIT FEE $ �UU { (Signature of Owner or Agent) _ The Commonwealth of Massachusetts >d Department of Industrial Accidents Office of/nvestigataons Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # am a horneoWner perforating at work myself_ I am a sole proprietor and have no one working in any capacity I am an employer providing workers'c ompensatidn for rrty employees working on this jot Company name. Address City Insurance Co. Policy Company name- Address. CrC Phom#k. Insurance Co. - - -- PoNcv#I` Faikrreto secure coverage as required under Section 25A or UGL 152 carrleadrtvthe irnposdton of criminal per�ltres ofatfii andlor one Years'anprisor �ielLassiuti Pena s in3tbeSams�fa JS 1� �S1 QOj that understand that a:copy of this statement may be forwarded to the Office of Aeration of the UTA for coverage verrrkation: I do hereby c erW undar the paras and penalties of pe4my Hast Hae Moroxo6 n provi*d above is&w and correct F'1 Signature Date Print name-. F'bone_# r Official use only do not write in this area to be completed by city or town offic iar or.Townbra. Q BU E]Check,d immediate response is required Lic El SW Contact person: Phone# ❑ He: _ El Otl s � Date. .. . �-7-. . . 0.1<".O RT:��o TOWN OF NORTH ANDOVER �r Oc PERMIT FOR PLUMBING ,SSACNUS� i This certifies that . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . has permission to perform . . - �: . . . . . . . . . . . . . . . . . . . . . . . . . . . . ',%plumbing in the buildings oft. .. . ! r` ?. . . . . . . . . . . . . . . at.� . ��` `` . . ' . .. l. . ' . . . . , North Andover, Mass. Fee,:: . . . . .Lic. No.. . . . . . . . . .! . . . f f� PLl'71VI'B)1� SPECTOR Check H l 6�- (� 5842 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS g Date Building Location � �(� e� / Owners Name (f /> g2ay 4/61 Permit#-0—`/i'� I Amount Type of Occupancy New Renovation Replacement Plans Submitted Yes ❑ No FIXTURES Ln Fin zrAwCOO O U z w x w W w A aLn 5 H a a a a d A a a H SLR1M RkS Ev1M M Hj0CR ZD FLOOR 3MFUM 4HiHD t . 5IH Hfm sMHf= 7MHfM SII3 iFIOQt (Print or type) ��^^ Check one: Certificate Installing Company Name 1 1j sq/.,tom 44 f� 11 Corp. Address / ElPartner. Warr,aX fr,aW ;11/�('sU Business Telephone �� �-,j VgCZ p irm/Co. Name of.Licensed Plumber: -7-ha,,, <' IS9 n /,/,a Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: lability insurance policy �/� Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made_ aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachustate Plumbin ode and Chapter 142 of the General Laws. By: S-19=e cli LicenseaTiumuer Type of Plumbing License Title ,cj 4 City/Town r7cense 74umuer Master Journeyman APPROVED(OFFICE USE ONLY r Date. NORTH 3?per. „�o ,e AtiO` I TOWN OF NORTH ANDOVER O V !' • - + PERMIT FOR GAS INSTALLATION s + °ye �• . y �9SSACMUSES•( This certifies that �, �`� . . . . . . .' . . . . .. . . . . . . has permission for gas installation . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at ��s5/ �- ? . . . . . . :,v ,CNorth Andover, Mass. Feer . . . Lic. No.��5/�v . . J . . . . . . . . . . —GAS IN4OR Check# (/ 4575 j MASSACHUSETTS UNIFORM APPLICATOWOR PERVIlT TO DO GAS HT11ING m (Type or print) Date / �,_7 p NORTH ANDOVER,MASSACHUSETTS = Building Locations A< � 00I.('61 ,77-anj- � Permit# 1(�6 7 V Amount$ �n/r�i?JPZ Owner's Name C19 p New❑ Renovation ❑ Replacement o/ Plans Submitted yo x x w w z o H x x z o w a z o z w C) H °x zCon a o H z F z w w o o w w w v z w Q a z a a o °o w °o w H a� x o ow a 3 a c� a x > SUB -BASEM ENT B A S E M ENT 1ST. FLOOR 2ND . FLOOR 3 R D . FLOOR -v 4TH . FLOOR 5TH . FLOOR 6TH . F L O O R 7TH . FLOOR j 8TH . FLOOR (Print or type), „/ Check one: Certificate Installing Company Name Q 0 /� Corp. Addre s 71�r �1��� C> r ❑ Partner. Firm/Co. Business Telep one �a'? Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy o/ Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ i hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massacbu State Gas Code hapter 142 of the General Laws. Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber / f lZry Tit City/Town ❑ Gas Fitter License Number ❑ Master APPROVED(OFFICE USE ONLY) n-l"urneyman J Location No. Date 12 MaRTN TOWN OF NORTH ANDOVER 41 f y Certificate of Occupancy $ °'E<�' Building/Frame Permit Fee $ ' s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r-25� i Check # 1,96k6 3507 ~`Building Inspevor 111-AW IT NO. APPLICATION FOR ANDOVEIR,' MA nitrNo . �-� 1.(II.NO. �� Q 2. ufc DRu(n O\I'nlRsnn U:�'11{ ' llOO!< PAGE--- I-- 01.E _---- /nnf. SIM mv. I()l ND. 1(Il \1 1<IN ✓ 1'UI<I'l 0i(if:111111 t)I N(i 1/1 020-LJ-L.- --�.J- (t\\•NUR'S NAML NO.tX:SIOI(ILS /J SIf I: ---- -------- (AVNLR*S ADDIMSS V IIASEMLNF OR SI.AII _-- ------- AR(1III E(-I-S 1JAKIP- e/ sl ill:(Nw FI(XNt I It.11iLRs 1 2 3 . III Ill DI_R'S NAME SPAN -- ---- DISIAWT IONLARESTIIUII.DIN(; DIKIFNSI(NJSOf Sit IS DIS I AN(E I ROM sl REE 1" 1)IPIGNSI(N4S(x-IX)S I S --- DISIANCLIRCN.ILOI'LIFiES-SIDES REAR 1)lf.l['NSl()t4S(N GIRDERS -- --- ---- ARLA(N 1!)I IIO?-lIA(jE IIEI(illl O FOL)NDATI(NJ TIIICKNFSS ISBtlll.OIN(;NEW A to SI(lUF I(k)IING X ---- IS BUILDING M-TERATION IS BUILDING ON SOLID OR FII I ED LAND \\`I1 1.BU1I.DlN(i C0IJI:oQM I0 RliQX IIRLMLNTS OF Ci,)OC IS IIlI11.UINti C(XJIJCC I LD 10 IOWN WAI VIZ - `i;:sII ('IIONS 3. 1'1(()I'L1(lVINFORMAIION IANUC(I,SI ESI. BLIx3.COST I-N(a- I Fit 1.(xIISEC1IONS 1-3 ESI. BLlxi.C'l)sI I'LRS(2.T1. ~ LSI. BIIxi.Ctri1 l'LRR(z)t.l ---- hl LC-TRIC MEI LRS Nit IS I BE ON(x I SIDE OF BUILDING SEPI IC PLRMI I ND. -- --- AI-IACI 1ED(,ARA(iL'SNIUSI CONFORM fro sTA1EFIRLRL(;IILA IIONS a. AI'I'ItD\'F:B B\•: 4e C ---- PI..ANS MAST IIF:FII fD AND APPROVED BY IIIIII.DIN(I INSPI:CIOlt BUILDING INSPE(A Off. - -- DAII:1'1111) ()Wt4LRs11:19 / C(xJIR.ILIIf 14 f A IA Nov I b 1999 l'(NJ IH.1 fill 4 •\I I1121'. O\\'IJIM( Al I 1111 WMA)A(;I NI _ BL)jLU.jj\JG D1=F= MENT . 11.1) /.l /'7 ;19 v .. . -- 1 '1�IZMI'i' NO. C� AI'1'LICA'1'ION i�OIZ ('l?IZt\11'I"I'O 131.111,0********NOIZ'1'11 AN!)OVl?IZ, MA nl\1'N11. t ,� ��.�_--- 1 I:III.NI). j O� 2. ull Ottu OI 1)\\•nt ltlllm - - ---------- DAAF BOOK S1113 mv. I N11. 1I)l %I WN ()\%-NER•S NAML f D No .tM SRMtIL•S SaL1j[[{rr ----- ----- U\VNI RAS AUI>It1iS5 BnS1iA1GNl'(N2 SLA!) ST ' r 2 3 ARCI111 E('I•S NAML e/ 5171:(N I LIXXt 11M1)LRS T—_-_ ---_ le lit III I)L•R'S NAME SPAN I►ISIANCI: IONLARFS'1 BUILDING DINII'NSI()NS OF SILLS _- DIS IANCEI-ROM SIRFU U I)InIIiNSIINJS(M IYJSIS I)ISIANCLIRUhILOI'LIIiES-SIDES REAR I)ttll:NSIONSO( (ARI)ITS ARI:AO LUI Fito mAGE IIEI(illl lM IOONDAIION fIIICI.NI:SS - ISNt11LU1NGNEW to SI/1:U1 MAIN(i IS[)UILDING.ALTERATI,(NN IS I)UII.I)IN(i ON S(M-II)OR Fit I E1)LAND Wil I.BUILDPA; lOf2CLx IIR[MLNI S 0:C(X)L= IS IiIIIL DING C()?41,;CC1 EI) 10 IOWN WA1 f:R - - ---- Ei'5lIR LAI I 1/)NS 3. 1'ItFt11 OPLI(I Y INOI1A.MIN . ESI. 8I.IX11.1X .C'(>dl' _ 1'AIiL I Fit I.(NII SECIIlNJ1 1-3 LSI. UI.IX;.COSI PLR SQ. FL LS 1. 811Xi.COSI PERR(X)tl LI IFUTRIC ME'I LRS All IST 8E ON(X I I SIDEOF 1)Ull.DIN(i SLIT IC I'Lltl 11l NO. AI"IACIIEDGARAGESMUS1M1,11: NtM tl)SFAhEIIRL'RUGM.A'lIONS a. AvIlItOVIA)N1': ---- PLANS MAST BE 1 I1 ED ANI)AI'I'ROVI=h 1)Y lll)II.1)IN(-.INSI'ECI(Mt BUILUIN(.IINSPECI 011 �� DAIt:1111:1) l � t)WNEItSlt=1N� l�U 1 �QO7- � L� 1, f�_- � CONIR.ILIII i r NOV 1 b 1999 \IGNAIllltlf tl\\'IJlatt A(II11011111:1)A(ilNhNAENT 111, as c BUILDR4 <<� 14 RMI I t IRAN 1 L1) 19 1� _ , WOOD STOVE INSTAtLLAFION CHECKLIST F'='lli!' EIUi Permit A building permit is required for the installation of any solid fuel burning appliance. The building permit and installation inspection are limited to the stove installation and not to the stove construction. Stove / s A. New V Used B. Type/radiant Circulating C. Manufacturer 6 14 w>e ( r ,b.No. Name/Model No. 1� 2')QQ Collarsize 3 'r Olmensionsi Height �I� r r 3 D r, Length fid. r r Width Chimney A. New Existing S. Size(flue area) C. Other appliances attached to flue(Number and flue size) 0. Prefab(Manufacturer—name and type) E. Masonry/Lined Flue liner BYO•A manwacmrert Unlined F. Height(refer to diagrams) cap rC' l �- 12! Nuti. 1 Z,�,ulna. i — Ig''►,uN. 14 n x HEARTH CHIMNEY HEIGHT Hearth(non-combustible) A. Materials B. Sub-ffoor construction C. Minimum dimensions(refer to ciacram) Clearances and Wall Protection(see s,cve in_,allat:cn c!e=_rances chart) A. Type of wall protection provided B. Clearances(refer to diagrams) \v II FIREPLACE CORtIER WALL'CENTER. 13 Thank you for purchasing the Breckwell Pellet of this manual is to help you do all three. PLEASE ,. Burning Stove.You are now prepared to burn wood read this entire manual before installation and in the most efficient, convenient way possible. To use of this pellet fuel-burning room heater. Fail- achieve the safest, most efficient and most enjoy- ure to follow these instructions could result in able performance from your stove, you must do property damage, bodily injury or even death. three things: 1) Install it properly; 2) Operate it correctly; and 3) Maintain it regularly. The purpose Keep this manual handy for future reference. 1 INTRODUCTION This stove has been independently tested and approved a power source for the blower systems and fuel feeding in accordance with the relevant portions of UL 1482-1988 systems and must not be burned with any type of coal "Standard for Room Heaters,"ASTM El 509-93, Oregon (see section 3.1). new rules for mobile homes (814-23-900 through 814- This stove is designed to provide the optimum propor- 23-909) and installation as a stove heater. tions of fuel and air to the fire in order to burn free of 1, This pellet stove, when installed, must be electrically smoke and soot. Any blockage of the air supply to or grounded in accordance with local codes, or in the from the stove will seriously degrade the performance absence of local codes,with the National Electrical Code, and will be evidenced by a smoking exhaust and a soot- 's ANSI/NFPA 70. ing window. For the best operation the ash content of This appliance is designed specifically for use only with the pellet fuel should be less than 1% and the calorific pelletized wood. It is designed for residential installation value approximately 8200 BTU/LB.Avoid high ash con- !: p 9 according to current national and local building codes tent fuels because this will rapidly fill up the burn pot and as a freestanding room heater. It is also approved as a eventually cut off the combustion air supply. mobile home heater which is designed for connection to Commercial and industrial installations of Breckwell an outside combustion air source. Pellet Stoves should not be used since operational F The stove will not operate using natural draft or without control is often not well managed in these settings. f, I 1 INSTALLATION .':,; t.. 2 1-PREPARATION 2&CL'EARANCE .' Factory packaging must be removed, and some minor The Breckwell P270OFSA has been tested and listed for assembly work is required prior to installation. Access installation in residential, mobile home and alcove appli- i to the rear of the stove is necessary. cations. Foam protective blocks must be removed from all blow- FLOOR PROTECTION(P2700FSA)minimum 24"wide ers and gear motor. This is a safety precaution. by 29"deep.The stove must be placed on a continuous NOTE: Normally, your dealer will perform these func- 30• MAX, tions. s BACKWALL ADJACENT WALL �34 MIR WITH 3• I I WITH I DACKWALL VERTICAL 3' HORIZONTALWITH 1' EXHAUST EXHAUST 3' JVERTICAL k I I ! J Q 48' MIN, EXHAUST 3' J¢ 3 O z ; Q 5' I' U 5' 5' Q T e MIMINUM SIDEWALL CLEARANCES STOVE DOOR FACE MUST BE EQUAL To OR PROTRUDE OUT FROM FACE OF ALCOVE. ALCOVE CLEARANCES WITH HORIZONTAL EXHAUST PAGE 3 ra , (grouted joints)noncombustible material such as ceramic be used at the terminus(see figure 2a).All connections tile,cement board, brick, 3/8"millboard or equivalent,or must be secured and air tight by either using the appro- other approved or listed material suited for floor protec- priately sized hose clamp and/or UL-181-AP foil tape. tion. Check local codes for approved alternatives. For mobile home installations only: 13/4"inside diameter Clearances are measured from the sides, back and face pipe may be used for the first 5 feet of combustion air (door opening) of stove body(see Figure 1). supply run. From 5 to 10 feet use 23/" inside diameter 24"----•-j pipe. No combustion air supply run may exceed 10 feet. Sources of Outside Combustion Air _ 1. A hole in floor near stove rear terminating only in a ]� ventilated crawl space. 2.A hole in the wall behind the stove. j TRIM 29" COLLAR j 3 x 6� h FLOOR PROTECTION }; (MINIMUM 24" WIDE X 29" DEEP) ® _ DO NOT USE MAKESHIFT MATERIALS OR COM- L, PROMISES IN THE INSTALLATION OF THIS UNIT. j INSTALLVENTAT CLEARANCES SPECIFIED BYTHE i, VENT MANUFACTURER. RODENT M23 COMBUSTION<AIWSUPPLY` VENTILATED GUARD ? For a mobile home installation the stove must be con- CRAWL SPACE nected to an outside source of combustion air. A 13/'° inside diameter metallic pipe, either flexible or rigid,may be attached to the inlet at the stove's rear(see figure 2). j A rodent guard(minimum %4"wire mesh)/wind hood must :31 WHEN 24" 2OUT,SIDE�'AIR IS'NOT`:-USED If a metallic pipe is not used for outside air on non-mo- bile home installations, then refer to your local or state ; code for proper application of a closeable outside air register. ' REAR EXHAUST . C❑MBUSTI❑N AIR INLET2 4 VENTING' 30 1/2" The Breckwell P270OFSA is certified for use with listed TYPE L-Vent, 3" or 4" diameter in size. The stove was + tested with Simpson Duravent brand. Class "A" chim- I 12 1/2" ney is not required. Refer to the instructions provided by 11 1/4" the vent manufacturer, especially when passing through L a wall, ceiling or roof. All vent connector joints must be secured with a mini- ; 2 3/4" mum of 3 screws. All horizontal connector joints must 6 1/2" be sealed with UL-181-AP foil tape. REAR VIEW DO NOT CONNECT THIS UNIT TO A CHIMNEY FLUE Kom SERVING ANOTHER APPLIANCE. PAGE 4 vAORTH Tovvn of dover 0 - � DSA C0CH, � over, Mass., �/ S 5� BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES THAT....../.Q. . 19,.............„.,.. .......OT-ro-O BUILDING INSPECTOR ...... ..................................... Foundation has permission to e�eet..�..40 401.e........... buildings on ......., .......�;�. �N �eY%4 ...... Rough to be occupied as........T .. .......it ....S+C V Y. N r s D S ti C �• Chimney ............... .................................................................... . . . provided that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 1�1 a PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONST-RUC ON T S ELECTRICAL INSPECTOR C Rough Service BUILDIN INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. 1 1 Location No. Date Z2'113 3117 TOWN OF NORTH ANDOVER 3+ : .. . .• of Certificate of Occupancy $ y�s',•°'E�� Building/Frame Permit Fee $ 3 CMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # G y '"`Building Inspector PERMIT NO. APPLICATION FOR PERMIT TO BUILD********NORTH ANDD/VER, MA AfAPNO. 090. LOTNO. d 03 8 2. RECORDOFOWNERSl11P DATE BOOK PAGE ZONE SUB DIV. LO'I NO. c� LOCATION c �1� PURPOSE OF BUILDING Jam- 4,�.*e—1 U an mak- A)0 5-V'Aw.J- 3`x I Ci 4P!Ar OWNER'S NAME �1 � t � � NO.OF STORIESter. ,U\— t 0% tin SIZE. OWNER'S ADDRESS t/i1 j- j� BASENIENTOR SLAB �l 2r Ci9LLYv`r ARCUFFECT'S NAN1E SIZE OF FLOOR TIMBERS` 1 2N BUILDER'S NAME �j SPAN DISTANCE TO NEARESF BUILDING Yy' DIMENSIONS OF SILLS DISTANCE FROM STREET DIMENSIONS OF POSTS DISTANCE FROM LOT LINES-SIDES REAR DINIENSIONS-OFGIRDERS AREA OF LOT FRONTAGE 11EIGHTOF FOUNDATION T1jICKNESS r: 1S BUILDING NEN SIZE OF FOOTING i• x IS 13UILDING ADDITION � L � � � AIATERIALOFCIIININE}' IS 13UILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND \17LL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTEp TO T0117J WATER k BOARD OF APPEALS ACTION, IF ANYIS BUILDING CONNECTED TO TOWN SEWER c IS BUILDING CONNECTED TO NATURAL GAS LINE 1NSTUCTIONS 3. PROPERTY INFORMATION LAND COST EST.BLDG.COST PAGE 1 FILL OUT SECTIONS 1-3 EST.BLDG.COST PER SQ. FT. .� EST.DLUG.COST PER ROOM ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. ATFACIIED GARAGES MUST CONFORAI TO STATE FIRE REGULATIONS A. .APPROVED BY: AW;w PLANS MAST BE FILED AND APPROVED BY BUILDING INSPECTOR BUILDING INSPECTOR ll,1T'E FILED OWNERS TELN '1 1 o-l3 Z7 CONTR.TELN 5� pZ1 c/ �3 CS t SIGNATURE OF-OWNER ORAUTHORIZED AGENT CONTR.LICN x6547� GEE 11.I.C.# $ z7-0 PERNICI'GRANTED / 19 °1 33:3 Revised 5/5/99 JAI FORM U = LOT RELEASE FORD INSTRUCTIONS: This form is used to verify that,all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliancewith any applicable or requirements. *** * ** * **APRLICANT FILLS OUT THIS APPLICANT PHONE _f-LOCATION: Assessors Map Number (5 I �'� PARCEL SUBDIVISION LOT (S) STREET b �c�l^�6h 'a'Z-� --�• ST. NUMBER USE RECOMMENDATIONS OF TOWN AGENTS: �,-• S CO SERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS �f TOWN P NNER DATE APPROVED oZ I DATE REJECTED COMMENTS J FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS V. PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING ii ISPECTCR DATE Revised 9l97 jm PROPOSAL Date. October 14, 1999 Project: CAVANAUGH RESIDENCE .aft. 1. Excavate form and pour approximately 17 l.ffrost wall and 4 x 6 pad with reinforcing. 2. Top pad with limestone and bluestone top. 3. Frame new roof to cover entry. 4. Remove and replace vinyl siding to accommodate new stiucture. .5. Install columns and Fypon Sunburst 6. Install new 9-11te fiberglassentry door l 1. Remove and'dispose of existing stairway. f 2. Remove and dispose of two(2)damaged deck boards. 3. InU waled c6mer on deck--Qth three (3) new joists and'deckarig. 4. Red=figure railing and add railing at new stairway,layout to b�synunetrical: 5. Construct new stairs with triad and riser detail;sct on cdnerete pad under stair. 6. Add permatrim skirt boards at deck perimeter 7. Add lattice (PVC).under deck perimeter. S. Rc stain deck. . 1. Replace caps that have blown off. 2. Chcck leak at vent collar,repair. We propose to furnish the above in accordance with the noted spermcations. This will be done fox' the sum of�� nrn i��s ($ tj� JW ). Payment is to be made as follows: Rcapeafnlly SuboAted. COMPANY. BY. Tuve DATEeAIV2� 0z: Nviro waeoouroedIAeaborspdaaeaaalk*w*Aaw""wWrots"gaidau��AL rap.eae.ov4dWU 1eeaehaaepeaft Pq�aM1W2eewaddd Lean.A Snaaoeshufe d l M FW WO"arm 3o days,An adte;"cuft sed aua�aey tai w�leaappted NOM ThipaVoulagIaaAldmmywit amLaaepYdanalissoday: MORTGAGE INSPECTION BAY STATE SURVEYING ASSOCIATES 234 CABOT ST., BEVERLY MA LOCATIONt-! NOTES: .l�.l.----T-----�N�©vim- �� •This is a Mortgage Inspection survey and not an SCALE : I = FT. DATE -_ -� I z - - - instrument survey,therefore this plot plan is for REFERENCE05:7___ mortgage inspection purposes only. s �S _ _ __ ___ _______ •This survey is based on survey marks of others. __ __ __ _ __ __ _____ _._, _ _ • Bushes, shrubs, fences and tree lines do=not To � 4 �/ 14AI j2�5 /YIC+' 7. Gc3 necessarily indicate property lines. ' ' ' - - ----- —- -�� ----- •In my professional opinion the building(s)are not-located The location of the building(s) as shown, either complied with the in the special flood hazard zone, as defined by H.U.D. local zoning set backs at the time of construction or is exempt •Whenever an offset is 1'± or less, an instrument survey from violation enforcement action under Mass. G.L. Title VII is recommended to determine prop. lines. Chapter 40A Section 7. -Offsets shown are approximate by tape survey. 57,zS 6SE'y —� 5�� i3vF�Ef� ZpnS C M Sq � I a / L N I e vuGE,Q_ 19 I CO3ov a<<N cif r9gss4c ( Q^ o y� R03ERT JAMES SOTIR . u N a The Commonwealth of Massachusetts d Department of Industrial Accidents " w Office of Investigations Boston, Mass. 02111 1b Workers'Compensation Insurance Affidavit Please Print Name, Location: City Phone am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this Job. Company name: �� ht�^►6ntll I Address 16 ✓L b61C-00 ij Lt. 9 P-1 n Cb City; a 4<-4!�V� 26)4 LM 16- Phone#: 10 4 3 Insurance Co. C- Policy# UJC- 1-Y4 D 3 3 3U Company name: Address City: Phone#: Insurance Co. Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name —tom' o- S , P-o�Ci—f Phone# 5z5 t' I ►0 43 Official use only do not write in this area to be completed'by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Lincensing Board ❑ Selectman's Office Contact person: Phone#. ❑ Health Department ❑ Other BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with.the provisions of MGL c 40 S 54,a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: y oy to n 6—ez— P ---mss y�b � i S�c�S L S n)C_ Wi xS - Location of Facility slgi6fture of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector BASIL E CONSTANTINE 6173346970 P. 01 O �' � � � w�c.e��' til�►ZG Registration 125 23 Type - INDIVIDUAL Expiration 12/11/99 THOMAS S. ROGERS 94 BROADRENCH 6098 WEYMOUTH MA 02191 ADMINISTRATOR i DEPARJIIENT OF PUBLIC SAFETY fi.. CONSTR CI QN)SUPERVISOR LICENSE i BifExpires: Birthdate: CS Ob5499; 12/06/1999 12/06/1960 � .� Restricted To �., 00 I j r iHOMASROGERS; 94 BROADREACH/DR ; 6098 i MEYHOUTH, MA 02191 i I 1411"� � j . Restricted To: 00 4 00 - 35,000 cf enclosed space t lA - Hasonry only 2 Falily Hooes Failure to possess a current edition of the ` I I ryassachusItts State Quildn� Godg i i is cause or revocation o his icense. i � NORT#Hq Town of Andover O _. 1 No.S'98 LAO dover, Mass. 1 k ilei 4t COCKICKEWICK I- CO ' ADRATED P\7\" S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System /� BUILDING INSPECTOR THIS CERTIFIES THAT I?%tP.---.a r........ill �...A)AM.Cj........�.r..A....1�.A...N..aI..V. �.................. Foundation has permission to erect... x I.. q. mOLramO belYp ........... ............... buildings on ....... ............................................................ Rough to be occupied as.51 1 !t.. N by bo hiiV�a......r'l p��r.. r.,@Ar t�f C Y Chimney ........................................................ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR 3 It UNLESS CONSTRUCTI NLi S Rough * Sao .......zn........................ M...... ......... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. No 2064 ,10RT1� TOWN OF NORTH ANDOVER jo p PERMIT FOR WIRING �,SSACHU`�� - This certifies that ......l .z. .f..................................................................... has permission to perform._.�: 'f-t--�..- L ._: ..... ' -� ...... ............ wiring in the building,f `"' ..... - ... ,North Andover,Mass. Fees ?...:......... Lic.No. .?/C. ..... t...i/;,, ....,................. �-ELECMICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer rt Office Use --/ G / ��jE (�DI21II1QIilUEtt�� Df �ttg$c�C�jUSEfL6 Permit No. Dict 39cpartlncnt of Vublic $afctq Occupancy d Fee Checkek4ZL_ �/9t) (leave blank) BOARD OF FlRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK rAll work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 1 0c00 Date (PLEASE PRINT IN INK OR E ALS 1V�RMAJIN) To the inspector of Wires`✓/�� 9� City or Town of �►'� f� 1/�-�`� The udersigned applies for a permit to perform the electrical work described below. 3 Location (Street & Number) t Owner or Tenant I Owner's Address ❑ is this permit in conjunction with a3 building permit: Yes No Appropriate Boz) (Check Purpose of Building Utility Authorization No. Existing Service Amps —J—Wits Overhead ❑ Undgrnd 13 No. of Meters New Service _._Amps—I Volts Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total No.of LG�hting Outlets No.at Hot Tube No.of Ttanstormers KVA No. of Lighting Fixtures Swimming Pool - Above9r 0 g nd.❑ Generators • KVA No.of Emergency Lighting No. of Receptacle Outlets No.of Oft Burners Battery Units No.of Switeh Outlets No.of Gas Burners FIRE ALARMS No. of Zones Tom No.of Detection and No. of Ranges No•at Air Cond. lora Initiating Devices No.of Heat Total Total No.of Sounding Devices No.of Disposals Pumps Tons KW No.of self Contained No.of Dishwashers Spaoe/Area Heating KW Deteetfom-sounding Devices Munidpal ❑Other No.of Dryers Heating Devices KW Connection No.of No.of Low Vbltag No. of Water Heaters KIN Sig" Ballasts ung No. Hydro Maaaage Tlrbs No.of Motors Total HP OTHER: T INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general taws 1 have a current Liability Insurance policy lncludkW Completed Operations Coverage or Its substantial equivalent. YES G NO O 1 have submitted valid proof of same to the OMce.YES O NO O It you have checked YES.please Indicate the type of coverage by checking the appropriate box. INSURANCE O BOND. O OTHERS O (Please SPedM (ExpkaUon Date) A Estimated Value of El e tricot k= .- S ,00-- / i 3 T Inspection Date Requested: Rough Final Work t0 Start P Signed under the Penalties of penury: LIC. NO. FIRM NAME LIC. NO. . 12316-- Licensee nnnAld A Rrnnkg _Signature (Zr03) X91-4008 Bus.Tel. No. Address 111 Morse Street. Norwood, MA Ail.Tel. No. OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have thisInauranCe coverage or Its substantial equivalent as re' equirement. Ownsr Agent qulred by Massachusetts General Laws. and thnl my slpnalure on this permit application wolves this r (Please crock one) S . � Gy — Telephone N°. PERMIT FEE ' __ (Signature of 0-mor or Agent) �.rrSA�i Location ©'i" / , t6� �casc )vrL No. 4'S Date ! � .. x +�Qo` TOWN OF NORTH ANDOVER a : Certificate of Occupancy $ Building/Frame Permit Fee $ CHUSEt� Foundation.Permit Fee?0: $ 106 —" i Other Permit Fee s,�ti ,, $ 1 t 7 Sewer Connection Fee $ Water Connection Fee $ TOTAL tv . Building actor a Div. Public Works ¢ v Location (' Date S �� 4t 'AOR 11 TOWN OF NORTH ANDOVER, Certificate.ofOccupancji $ ' A �o -_ ., ,' Building/Frame Permit Fee $ � sniiw4 Foundation Permit Fee $ �D�•C) i SSAGNUSE tf7 . ' Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ S l�A Q 2y Building Inspector 0 . 7298 a Div. Public Works '''Y",V.�y�^._id.'i.rSj;._ ..y.. :�-.. _„M,�roy_r'.�.'^ --�^tii-�n-'9' ""#-'ar,,,.,q,•,r' '�".•v r No. � Ute . <r Date "ro��; E AORTq T WN OF NORTH ANDOVER 'pAaLop Certif Cate-of Occupancy $ 41 Building/Frame Permit Fee $ cMusE� Foundation Permit Fee $ - _ Other Permit Fee -$ 17, �= 00 -Sewer Connection Fee $ S Water Connection Fee $ a TOTAL �$-,2�,�C�/D' � ` �? BUIdin`g Inspe _ 3orem � °PER1fIT NO. A APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP K40. I LOT NO. 1 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE 2_ SUB DIV. LOT NO. LOCATION I?o,3G MbU PURPOSE OF BUILDING OWNER'S NAME Tei NO. OF STORIES .5 C,,4 SIZE OWNER'S ADDRESS /03 y)HYt�XC�+'i iGA 1A, ',t:i0 � BASEMENT OR SLAB -Ktn�T, '{✓L` �'l V ` /�� y� ARCHITECT'S NAME L" SIZE OF FLOOR TIMBERS - IST 4�N4DC' !/ SRD BUILDER'S NAMEr`� _������ SPAN��e.6• - DISTANCE TO NEAREST BUILDING`�-2 DIMENSIONS OF SILLS a,k ti 00, --- DISTANCE FROM STREET r POSTS el(, CaCv�5 DISTANCE FROM LOT LINES—SIDES//_�� REAR GIRDERS AREA OF LOT ���/ '�/'�iT�-ffC��� FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW �' SIZE OF FOOTING G `"6 C• C'�/ X IS BUILDING ADDITION MATERIAL OF CHIMNEY G1 IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER ;of BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER �y�•� •'- IS BUILDING CONNECTED TO NATURAL GAS LINE �sS 4 a PROPERTY INFORMATION INSTRUCTIONS �( 1Qil� LAND COST SEE BOTH SIDES EST. BLDG. COST LESS FDA 'EJ: / lJ O E� 2or co �` ��'� �� EST. BLDG. COST PER SQ. FT. PAGE 1 FILL OUT SECTIONS 1 - 3 � __���������� •�'�ryr/� �'� PAGE 2 FILL OUT SECTIONS 1 - 12 FRAME/ 1� MI G' ���i J EST. BLDG. COST PER ROOM cl SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDINGJ �& 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS [/ PLANS MUST BE FILEDANDAPPROVED BY BUILDING INSPECTOR ^f DATE FILED �� I i BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT U FEE Z .� PERMIT GRANTED OWNER TEL:{ `s8.t"o�7Sfi PLANNING BOARD CONTR.TEL.# 19 --� CONTR.LIC.# G_T _F BOARD OF SELECTMEN 1; f MAY 2 7199A G BUILDING INSPECTOR 7 f ' y BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I i RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 I �'— CONCRETE BLK. PINE _ BRICK OR STONE HARDw 0 PIERS PLASTER _ DRY WALL - UNFIN. — — — - 3 BASEMENT 11 AREA FULL - FIN. B'M'TAREA _ 14 'h '/, FIN. ATTIC AREA _ NO B MT FIRE PLACES HEAD ROOM -MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ h WOOD SHINGLES EARTH _ ASPHALT SIDING HARDNr✓'D ASBESTOS SIDING COMMGN VERT. SIDING ASPH.TILE - F STUCCO ON MASONRY STUCCO ON FRAME BRICK N MASONRY ATTIC-STRS. & FLOOR f L BRICK ON FRAME I ,».,..,s,,,K„-...,w . - ,;I','r irl Eau CONC. OR CINDER BILK. - STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY - WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR ` +! TILE DADO 6 - FRAMING 11_. "HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC Isl 13rd NO HEATING 4 P I FORM U - IAT RELEASE FORM INS'T'RUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction W have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** --, n APPLICANT: �Oj/ � ��-., Phone LOCATION: Assessor' s Map Number Parcel Subdivision /U0h_'_1-t_ A-NPDyea. �41S Lots) �6 Street 12-odexfooiv 1',_ 12 St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved v Conservation Administrator Date Rejected Comments , Date Approved 2 Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Sen-- ' c Inspector-Health Date Rejected Comments Public Werrs - sewer/water connections 5 / 77S V - driveway \permit 5/24 Fire Deeartment Received by Building Inspector . Pf_' _ n� Date MAY 2 71994 ..__� _J r �J :27, J ti T rf{ r $ e 1 m \ ti s ` L `�� \ N t3Gs4. \�4` LOT r IA � a > at Ku y o� PIAN w \ 10 ClYIt, G 318870 �F 1% 17�,.�!(r •���, STS ���. s�0 t .tt NOTE: ALL UTIUTY LOCAIIONS ARE TO BE FIELD VERIFIED BY THE GRADING ` SM Pl` 517E CONTRACTOR. La" m As C LbT I u S e T P,4%C K F 1 G 5 - 2 c- - C, ' ,f ^ 2 NORTH ANDOVER WIATM KORTH AN OMR, 11A >r�rl.alm b LAND PLANNING TOLL BROTMRS, INC. W!i ENGUMRING & MVEY 1800 wzgT PAN MM SMRO. w► 0m., 187 HARTFORD Atrlvr' M DMINOUAK ILA 08010 (908) 966-4130 IrA7X (608) sae-6054 /N � f LAND PLANNING ENGINEERING & SURVEY June 2, 1994 Building Inspector 120 No. Main Gtreet North Andover, MA 01845 Attn: Walter Cahill Re. Foundation Hole Inspections Lots 1f, - North Andover EStates To whom it may concern, on June 1, 1994, our office in,,pectcd the LvuiidaLivri livlu for Lot- 16 . Tlie liiLenL of Lhe 111k3pu(,:ti(.)ri was to determine if the Boil c uridit ions where adequate for the intended u i: . The intended use being a fouLicig bdse Lur L.1iu c uxj5tx*uction of single family (jwelli.ng of the type coon cl,owhcxo on 3iLe. Our observations were that the foundation hole had been excavaLed trliz•ough Filled soil and original topalai.l a subsoil into the underlying firm ;silty gravel & oil . A small portion of the foundation hole requireci fill Lo be pluc:ed to maintain the footing grade. The area which required fill, was limited to the two fear uuint!r* of the foundation hole. '14ie depL11 of fill appeared to be miiaimal and was c:vvuzed with 3/4 inch stone. The filled aroaw hacl been Lulled iud were adequately cGmpac_ui' !d Lo prevent po„ibl c 3eL L l inch . IL id our opinion that the foundation hulu was adequately prepared and it capable of pruviclt!d Olt-- riec:essaiyy bearing pressure for the consLrucLlun us planned. Sincerely, c Norman Hill, P.E. �ar _ NcrztiN r /cl HG. ILL - GVIL p N0.31887 �Q'/STE'R NA one GrefLon Common 1157 Hertford AVCl lue Sunnyside Avenue 6ArJ MmnPoneatt Street Grafton,MA 015» t)oingnam,MA 02019 Holcfen,MA 01520 Hallfav,MA OE338 C17 M4 a�aA nUtj UJW-a�LIe soe 966-tet t30 506 829 300© I 1. l � NORTFy Town of :20 over O I No. 205 ' � . i � �y� ? � o : -�A�Tort `� `� dower, Mass., 19 Py COCKICKE-ICK �L\V OA?ATED S BOARD OF HEALTH R. M IT T D Food/Kitchen Septic System %go PA BUILDING INSPECTOR ................................. THIS CERTIFIES THAT... Q.�..`.... .If�.. ..... �.....T Foun i ' � PARIM-0 oug anon has permission to erect��i���fbuildings on ..... ... ... . ... ............... ... . .. ... ..... Rough Chimney y to be occupied as�� �. i . ��! .�. .. � provided that the person accepting this permit shall iff every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspe� �lt i � r0yi of Buildings in the Town of North Andover. PLUMBING INSPECTOR REGULATED BY PARA. 114.8-S. B.C. VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MC 1FEE PAID 6G U Final Of l ��D U ELECTRICAL INSPECTOR UNLESS CONSTRUC ON ST TS PERMIT FOR FRAME/BUILDING Rough ............ ........... Service DATE: FEE PAID: -- - BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT FROM LAND PLAHN I NG BELL I NGHAP11 PHONE NO. : 509 966 5054 PCI1 .1 , 4 -W- s � R 7 rti L •% LoT I W OF e N 4� 3 y ; CIVIL -. p NO.318$7�Q 4 `S � �S7$4• '� f; L4 1, � :zo , NOTE: ALL UTIUTY LOCA110 15 ARE To BE FIELD VERIFIED BY THE GRADING / SITE PIAN SITE C6NTRActbh. IUCAM a L-t -. r c C ( ► r'. IDT 1 U. S e'Y e A c k F - s ^ - c ' _ NaN RO TH ANDOM MA "wow "a LAND PINING TOS.. BROTHERS, INC. sir POW "mvx CERTIFICATE OF USE 8t OCCUPANCY l,pir- A of Morth Andover Building Permit Number 205 Date NOVEMBER 1 , 1994 THIS CERTIFIES THAT N DRIVE Lot 16 - Type D 4 ROSEMO T THE BUILDING LOCATED ON 16 ( # ) v MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/2 CAR IN ACCORDANCE GARAGE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO TOLL BROS . Philmont Dr. ADD \ S t ' n on Va e PA \ r \ Building Inspector " O R s4• Town 0 Noil over 4;, )) i✓ a E,A ' Z. s �'� I 4 .r s' :North Andover, Mass., 19 p PE RM BUILD BOARD OF'HEALTH ,,. Food/Kitchen Septic System IT TO BUILDING INSPECTOR THIS CERTIFIES THAT... .J0 411.... *0................................. i Foundation i has permission to erect& ,� buildings on1.jyf.S...... ��.A/r..#0440.VCS Rough 0/,r -0-1—94— to be occupied as���� �. � .5. e •A � Chimney provided that the person accepting this permit shall iff every respect conform to the terms of the application on filein Fina this office, and to the provisions of the Codes and By-Laws relating to the Inspe , b i�l��D � rd .T of Buildings in the Town of North Andover. � 11 MBI PLUG NSPECT R REGULATED BY PARA. 114.8-S. B.C. �- VIOLATION of the Zoning or Building Regulations Voids this Permit. FEE PAID �G U PERMFF EXPIRES IN 6 MOM . �-�,, v � `` � 19 ELECTR CAL IN ECTO UNLESS CONSTRUCTION ACTION STA_ S . Rou �� � PERMIT FOR FRAME/BUILDING ............ ery /�> , �i � .............. . ........ ..... ............. ...... .. ... • 8.S�� FEE PAID' BUILDING INSPECTOR Fin DATE. Ocaip n(7y Permit Req2.c*ffecl to Occupy Bt�ilcling GAS INSPE TOR Rough ive�'i s G K Display in a Conspicuous Place on the Premises — Do Not Remove t60410 0 4 LJg No Lathing or Dry Wall To Be Done ` Until Inspected and Approved by the Building Inspector. Burner FIR ` ARTMEENNT � ° .i1, �'✓�J Q-k b PLANNING h r°" 9FINAL CONSERVATI ��Z� N street N°' • �y Smoke Det. a 1 f`� TRY PERM ! P -f I Iry SEWER/WATER FINAL DRIVEWAY EN �, A 0►� +M�7'r� 'Lo��e vf?xn`�.Z, cwzt�t evL - fvP f-Yc�#� ttgjA�oa- oWft FA 4ea 00,.r 44-c, wt��n�Lut�c. t��we.l,l ( o( � CC(— tut(50 CC-tut02 ��- 4,oac,i- � �'Z •